Analysis Of Risk Factors Of Intestinal Obstruction Complications After Radical Cystectomy

Objective: To investigate the risk factors of intestinal obstruction after radical cystectomy.Methods: To analyze retrospectively the clinical data of 184 patients who underwent radical cystectomy for bladder tumor from January 2010 to August 2021.According to the occurrence of postoperative intestinal obstruction,patients were divided into intestinal obstruction group and non-intestinal obstruction group,and the correlation between clinical variables and postoperative intestinal obstruction was evaluated.Results:The patients with postoperative intestinal obstruction had more intraoperative blood loss(≤400ml vs >400ml,P=0.013),lower serum potassium(3.85±0.59mmol/L vs3.59±0.67mmol/L,P=0.032)and albumin(29.29±4.26g/L vs 26.8±4.29g/L,P=0.003)and later time to get out of bed(≤48h vs >48h,P=0.023).There was no significant difference in age,BMI(Body mass index),sex,nationality,history of abdominal operation,hypertension,diabetes,anemia,mode of operation and urinary diversion,blood transfusion during operation,operation time,pathological stage of tumor and pelvic lymph node metastasis between the two groups(P>0.05).Multivariate Logistic regression analysis showed that large amount of intraoperative bleeding(OR=2.685,95% CI1.076 ～ 6.700,P=0.034)and late time of getting out of bed after operation(OR=4.264,95% CI 1.198～15.180,P=0.025)were the risk factors of postoperative intestinal obstruction,and high postoperative albumin(OR=0.905,95%CI0.822～0.997,P=0.042)were protective factors.Conclusions: Intraoperative blood loss,postoperative albumin and postoperative time out of bed are related to the occurrence of intestinal obstruction after radical cystectomy,especially when intraoperative blood loss is greater than 400 ml,postoperative albumin is lower than 30g/L and postoperative bed rest time is more than 48 hours.